Student Course/Class Fee Opt-Out Request
Student Name:
Student UCID:
Term:
Example: CSD 6011-001 (7151) Multicultural CSD
Class
Subject
Class
Catalog #
Class
Section #
Class
Number
Class Title/Description
Course/Class
Fee
Confirm
Opt-Out
☐
☐
☐
☐
☐
I have verified via the Bursar website (http://www.uc.edu/bursar/fees.html) that the above referenced classes and
associated fees are eligible for students to opt-out of. I also understand that by opting out of these fees I will not be
entitled to the automatic delivery of the associated book, supply, or other material or item that other students receive by
not opting out. I fully accept the responsibility to obtain these items on my own and understand that failure to do so
timely will impact my ability to stay current in class and may affect my academic success.
Student Signature
Date
STAFF USE ONLY BELOW THIS LINE
One Stop Staff Initials/Signature & Date:
Post Credit(s) to Student Account:
Add Comment to Student Account:
Bursar Staff Initials/Signature & Date:
FILE: Document1
(40160002xxxx)
Item Type Used:
☐